February 5, 2019
 
Today’s Top Story

Study Evaluates Efficacy of Tranexamic Acid in Reducing Blood Loss and Morphine Consumption in TKA Patients

In a study published online in The Journal of Arthroplasty, researchers found that intra-articular tranexamic acid (IA-TXA) and intravenous tranexamic acid (IV-TXA) could reduce perioperative blood loss in total knee arthroplasty (TKA) patients. Primary TKA patients were randomized into three groups: no-TXA use, IA-TXA use, and IV-TXA use. Compared to the no-TXA group, perioperative blood loss was 193.26 mL lower in the IA-TXA group and 160.30 mL lower in the IV-TXA group. The no-TXA cohort needed significantly more blood transfusion units than both TXA groups. IA-TXA patients had lower visual analog scale (VAS) for pain scores at postoperative hours six, 12, and 24 and required 18.26 mg less total morphine at two days postoperatively than the no-TXA cohort. VAS scores and required morphine did not significantly differ between the IV-TXA and the no-TXA group.

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Other News

Study: Does Backpack Weight Contribute to Low Back Pain in High School Students?

In a study published online in BMC Musculoskeletal Disorders, researchers evaluated the correlation between low back pain and heavy backpacks among high school students. A total of 957 students aged 14–19 years (mean age, 16.7 years; 56.4 percent male) spanning 950 high schools in Kuwait were included in the study. Overall, 70.3 percent reported experiencing low back pain during their lifetime; six- and one-month prevalence rates were 49.1 percent and 30.8 percent, respectively. Females were more likely than males to report low back pain. Neither univariable nor multivariable analyses found a correlation between the school bag’s absolute weight and lower back pain. In univariable analysis only, the weight of the school bag as a percentage of the student’s weight was associated with low back pain. Researchers observed a significant correlation between the perceived heaviness of the school bag and low back pain.

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Study: Prolonged TJA Operative Time Increases Infection Risk

Total joint arthroplasty (TJA) patients with prolonged operative times may have a greater likelihood of postoperative surgical site infection (SSI) and periprosthetic joint infection (PJI), according to a retrospective study published online in The Journal of Arthroplasty. A total of 17,342 patients underwent primary unilateral TKA and total hip arthroplasty at a single institution between 2005 and 2016 and had a minimum one-year follow-up. The total 90-day SSI rate was 1.2 percent, and the one-year PJI rate was 0.8 percent. Patients whose surgery took longer than 90 minutes were nearly twice as likely to sustain SSI or PJI (2.1 percent and 1.4 percent, respectively) than those whose operative time was between 60 and 90 minutes (1.1 percent and 0.7 percent, respectively) and 60 minutes or shorter (0.9 percent and 0.7 percent, respectively). Multivariate analysis found that each 20-minute increase in operative time increased 90-day SSI risk by an odds ratio (OR) of 1.346 and one-year PJI risk by an OR of 1.253.

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Study Compares Orthotic Device and Cast to Immobilization Cast in Ankle Fracture Patients

In a study published online in The BMJ, treatment of isolated stable Weber B type ankle fractures with a cast or orthotic device for three weeks was noninferior to six-week immobilization in a cast. Skeletally mature ankle fracture patients aged 16 years and older (n = 247) were randomized to six-week cast immobilization (n = 84), three-week cast (n = 83), or three-week simple orthosis (n = 80). Of these patients, 212 completed the study. At 52-week follow-up, all groups had similar mean Olerud-Molander Ankle Scores (six-week cast group, 87.6; three-week cast group, 91.7; and three-week orthosis group, 89.8).

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HHS Proposes Eliminating Safe Harbors for Medicare Part D Drugs

The Department of Health and Human Services (HHS) unveiled a new rule that would help lower drug costs under Medicare Part D and Medicaid plans. Per the proposal, rather than drugmakers paying rebates to pharmacy benefit managers, patients would instead receive discounts on their medications. HHS Secretary Alex Azar said if the rule goes into effect, he expects commercial insurance companies to follow suit and eliminate drug rebates as well.

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AAOS Now

ABOS Launches Web-based ‘Open Book’ MOC Pathway

The American Board of Orthopaedic Surgery (ABOS) has released its new Knowledge Assessment pathway in Maintenance of Certification (MOC). Through the Web-based Longitudinal Assessment (ABOS WLA) program, current ABOS Board-certified orthopaedic surgeons can fulfill MOC Part III requirements by completing an online yearly assessment. Those choosing the WLA pathway can begin filling out the assessment on April 15.

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Your AAOS

AAOS Accepting Commentary on Newest Proposed Guideline

The newest AAOS Clinical Practical Guideline on the Management of Rotator Cuff Injuries has completed peer review and is entering the public commentary stage. To provide comments on this guideline, please follow the public comment instructions. The deadline to submit a comment is Feb. 18.

Access the public comment instructions…

 

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